Questionnaire - Measurement, Learning & Evaluation Project

SECTION 1: BACKGROUND CHARACTERISTICSQno Questions and filters Coding categoriesSkiptoHOUR……………………………….[__|__]RECORD START TIME:MINUTES…………………………..[__|__]Thank you for agreeing to participate in this survey. As I mentioned in asking for your consent, we are looking to assess your health andinformation needs. To begin, we are going to ask you some background questions about yourself.Nagode da amincewar ki a wannan binciken. Kamar yadda na fada miki wajen neman izininki, muna neman bayanai akan lafiyar ki Da farko,zamu tambayeki wasu mahimman abubuwa game da ke kanki.Q101In what month and year were you born?A wane wata da shekara aka haife ki?How old were you on your last birthday?MONTH . . . . . . . . . . . . . . . . . ………[__|__]DON'T KNOW MONTH . . . . . . . . . . . . . . 98YEAR . . . . . . . . . . . . . . …..…[__|__][__|__]DON'T KNOW YEAR . . . . . . . . . . . . . . 9998Q102Q103Q104Shekarunki nawa cikakku?COMPARE AND CORRECT Q101 AND/OR Q102 IFINCONSISTENTHave you ever attended school formal or Qur’anic?Kin taba shiga makaranta?What is the highest level of school you attended: Quraniconly, primary, junior secondary, senior secondary, or higher?Mene ne zurfin ilmin ki: Makarantar Alo (Al qur’ani) kadai,firamare, Karamar Sakandare, Babbar Sakandare ko gaba daSakandare?What is the highest (class/year) you completed at that level?AGE IN COMPLETED YEARS…..…[__|__]YES…………………………………....1NO …………………………………….2QURANIC ONLY……………………...0PRIMARY………………………….…..1JUNIOR SECONDARY (JSS)……... 2SENIOR SECONDARY (SSS)……...3HIGHER…………………………...…...4Q106Q106Q106Q105Aji nawa ne mafi zurfi ki ka kammala a wannan matsayin?CLASS/YEAR……………………[__|__]Q106Q107Q108Q109IF NO YEAR COMPLETED, WRITE “00”What is your religion?Menene addinin ki?How religious do you consider yourself? Do you consideryourself …READ OUT RESPONSESYaya ki ka dauki kanki a addinance? Kin dauki kan ki mai yinaddini sosai , mai yin addini dai dai gwargwado ko ba mai yinaddini ba…..To what degree does your religion influence the decisions youmake about family planning? Would you say that your beliefs:never, somewhat, often, or always influence the decisions youmake about family planningA wanne matsayi ne addiniki yake shafar kudurin da kike yigame da tsarin iyali? Zakiiya cewa addininki baya shafarkudurin da ki ke yi game da tsarin iyali,yana shafar kudurin kiko da yaushe/ ko sa’ i sa’ i .What language do you usually speak at home?Wane harsheki ka fi amfani dashi a gida?CATHOLIC…………………………..1PROTESTANT/OTHERCHRISTIAN……………………….…2MUSLIM…………………………...…3NO RELIGION ……………….…..…5OTHER______________________6(SPECIFY)STRONGLY RELIGIOUS ……….…1SOMEWHAT RELIGIOUS …….…..2NOT AT ALLRELIGIOUS…….………………...….3NEVER…………………………….…1SOMEWHAT……..……………….…2OFTEN/FREQUENTLY………….…3ALWAYS…………………………..…4DON’T KNOW (ABOUTFP)………………………………....…8HAUSA………………………….……1YORUBA………………………..……2IGBO…………………………….……3ENGLISH……………………………..4PIDGIN ENGLISH………………..….5OTHER______________________6(SPECIFY)Q1094